Provider Demographics
NPI:1871087577
Name:NEMES, LISA ANNE (MD)
Entity type:Individual
Prefix:DR
First Name:LISA
Middle Name:ANNE
Last Name:NEMES
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:LISA
Other - Middle Name:ANNE
Other - Last Name:VITELLO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:1245 ROBSON LN
Mailing Address - Street 2:
Mailing Address - City:BLOOMFIELD HILLS
Mailing Address - State:MI
Mailing Address - Zip Code:48304-1536
Mailing Address - Country:US
Mailing Address - Phone:248-909-0648
Mailing Address - Fax:
Practice Address - Street 1:1245 ROBSON LN
Practice Address - Street 2:
Practice Address - City:BLOOMFIELD HILLS
Practice Address - State:MI
Practice Address - Zip Code:48304-1536
Practice Address - Country:US
Practice Address - Phone:248-909-0648
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-06-18
Last Update Date:2021-05-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI4351028274208000000X
MI4301115202208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics